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Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 82 Lakeside Drive East, Centerville, Mass 02632 Village Owner Joseph Rogers Address 82 Lakeside Drive East, Centerville Telephone 508-775-5625 Permit Request R=iace roof — 2400 sq. ft. �E771 f Pr Jl� Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost $6,250.00 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family M Two Family ❑ Multi-Family(#units) Age of Existing Structure 28 yrs. Historic House: ❑Yes CA No On Old King's Highway: ❑Yes ®No Basement Type:, M Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 1,800 Number of Baths: Full:existing 2 new Half:existing new Number of Bedrooms: existing 2 new Total Room Count(not including baths): existing 5 new First Floor Room Count Heat Type and Fuel ®Gas ❑Oil ❑ Electric ❑Other • Central Air: ❑Yes ®No Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes ❑ No Detached garage)]existing ❑new size 1 car Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:M existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes C No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name HomeWatch, Inc. Telephone Number 508-89j6_-1200 01 Address 12 Tower Hill Circle License# 01 S a1s Brewster, MA 02631 Home Improvement Contractor# f ZS qS 3 Worker's Compensation# n C AL I �I ALL CONSTRU TIO BRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO , SIGNATURE DATE f FOR OFFICIAL USE ONLY s PERMIT NO. r DATE ISSUED MAP/PARCEL NO. i ADDRESS VILLAGE ' OWNER , DATE OF INSPECTION FOUNDATION FRAME ' INSULATION FIREPLACE -'t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t•... n ti GAS: ROUGH FINAL (� FINAL BUILDING r a DATE CLOSED OUT } ASSOCIATION PLAN NO. e ' { AI, Pllal0® CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/YY) 5 .:.. 10/12/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BYAM BROS INS AGENCY COMPANIES AFFORDING COVERAGE 191 PAWTUCKET BLVD _...._............ ....._........ ........_............ ._.._..... . ......................................................... LOWELL MA 01854 COMPANY LETTER A _..........................................._.__....................._.._............................ .................._................................... . ............................................................ ......................................._.._......_.......... COMPANY B INSURED LETTER ....... ................. COMPANY c HOMEWATCH INC LETTER ................................................ ......... ............... ..__......... ................. ........_............._.............. . 12 TOWER HILL CIRCLE COMPANY BREWSTER MA 02631 LETTER D GUARD INS GROUP _....._........................._... ................... ........_.. .._......................._............__...._....... COMPANY E LETTER COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _.............................. _.............................._..............................._....................................._.................._......._...... ............................................................_.................. ....._.. CON TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE :POLICY EXPIRATION! LTR: LIMITS DATE(MM/DDNV) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ ................................:........................................ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ _._.._ ..._._.. .. .... ........ _... CLAIMS MADE: OCCUR.: PERSONAL&ADV.INJURY $ ....................... OWNER'S&CONTRACTOR'S PROT.: EACH OCCURRENCE $ .......................-................._........__......................_...... . FIRE DAMAGE(Any one fire) :$ ........................................................................................ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT ALL OWNED AUTOS ........ BODILY INJURY $ SCHEDULED AUTOS (Per person) _........................ ....................... HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ _.................................................._......_...._......... GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ _.......................................:.......... .....__...._......._...... UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION HOWL 012 813 5/14/9 9 5/14 O O X STATUTORY LIMITS EACH ACCIDENT..._.................$:1 O.O....O.O.O,....::..,: AND ............._.._......__.................._.:....._.....0. !.................._.... DISEASE--POLICY LIMIT S500, 000 EMPLOYERS'LIABILITY __..........................................._.... .. ....,...._.._.... DISEASE--EACH EMPLOYEE $1 O O, 0 0 0 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HC,DER' CANCE4LATIQI!7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE THE TOWN OF BARNSTABLE LEFT, BUT FAILURE TO MAIL$jQgr8hOT�ICFFhs�l��tfLEr�N1F S�E�HNIr% BLIGAki�TOj,NIOR ATTN: BUILDING DE PT LIABILITY OF ANY KIND UPO ITHE COMPANY, ITS AGENTS OR REPRESENTATIVES. 367 MAIN STREET HYANN I S MA s 02601 AUTHORIZED REPRESENTATIVE FRANCIS COULTER ,,(�nT, ACORD 25-S (T(90) � AC RGQI QEIQN 199a` �f E A The Town of Barnstable BMWSTABM Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 E Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: New roof Estimated Cost $6,250.00 Address of Work: 82 I;akeside Drive East, Centerville, MA 02632 Owner's Name: Joseph Rogers Date of Application: October 12, 1999. I hereby certify that: Registration is not required for the following reason(s): 0 Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I her a 1 o permit as the agent of the 9wner: �5 3 ate Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav A � R hzcguJ'atioRS ns RE I�ZRA5IOYS ar One Ashburton Place - Room 1301 Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR Registrati 125453 Expiration 12/18/99 Type - PRIVA T,-- RATION HOME 'SCAPE INC JUSTIN J , WHARTON 1142 MAIN ST C'HATHAM MA 02633 t . - ! i al Accidents =•�_ _--..� Department of Industri is , = OfffcDOff�e981fODS _ — 600 Washington Street - - Boston,Mass. 02111 Workers' Compensation Insurance Affidavit " e: !iO tCitv n: 'l hone# ❑ I a homeowner p aH work mm� ❑ I a sole etor and have no one za au C,tv ensation for my employees woddng an this job. .::xfi'•.'�'r:v.{:::.:•?.}}:G:?fi}}}:fit}}:?........';•::.-•.v:::;.::v{nw.................:..:.. as g . .......::............... ,.-,Tx..:,.. ....................... .:.:.�:::.:......+..... .... :] Z" am �9a n..... . 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TYPE OF CONSTRUCTION ..............�Xz,.p.,4:"..Ke.......��¢"�.�.. :...... ............................................................... ............19.'Zy1. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location � ��1�.- ..�r•GiAf , 1 ..... ................ I�2!✓sL.<i�z ......................... ................. ................... ProposedUse .................1` .� �dJ .................................................................................:.............................................. Zoning District ............... .>.............................................Fire District .�..:P. 7"16e;.,<2_14GF..... Name of Owner ......f�.Pd �-.... � � .... .....Address ..........i3.;7d..",e..4.odl........Xr.....Z/�to, o4 4, 4:5 Name of Builder ....X/�y'.... F :.... ............Address .......... f!:1.Zd�!!.. .5......:,�/V4 ,e!/<.,J.......:........ Name of Architect .....W-OJ'I(C-r......�:Cc.C�31..7 ..............Address .....6A44:....046VV/.r;�W Numberof Rooms ...........,.................................................Foundation .......er,:�W...<'i.._...................................................... Exterior ...........w l.T .... l'....... X/,Y/.we*W.Y..........Roofing ........... T............................................:..... Floors .................® -.............................:.........................Interior ............. ✓Lu.��. ............................................ Heating .........A . .. .:.......... .Plumbin ^��'� ...�?....................... g ..................2 ....................................... J Fireplace ...................... -.2.......................................................Approximate Cost JJ.,�tn.......... . . ......................yy............ ....... Difinitive Plan Approved by Planning Board ________1_���_____________19_,��. �`� Diagram of Lot and Building with Dimensions ep it. lei 00 _ lay OU w za. H � � M _j z l � = m } a, � LJ_ 0 LaJ U 0 N ® Cn Z [:rL = Lit 0 CO LLJ <14 _� � a < 1• 0 ., < a- < ^ W A6 d a+' LLJ F-- 1, . • ' = z j Lau .�.41��°�'rr✓�' 7�/� . tin ¢ a_ n hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... ..... .!° . . ��� �.ram . Mar Realty Corp. \ � No —. Permit for .....9nP.. ........... single f ` --''=`==='''= 'w ' Lakeside Drive Location -----------------.----. --------��.���������---`------.. ' Mar Corn` ' Ovvnar ^~"���� --s° ---------^ --'' -------' | Type of Construct on --�����-------- -----^-------------------''' Plot ............................ Lot --.�l2� ---................ Permit Granted ......July .�9—.. 19 72 ' . ' . ^ ~ Date Completed �� � PERMIT REFUSED - ~v lg U� � .----.~---------------.. .. -- --... — -----.--'''.'' '.' ' '' '.-------' �^ ^—~--.--...--,_--.--~.,.------... ^—.--------.-----.---...—..---. ----'—'------'--'—'---`—'^---^—' | � . | � � Approved .. lA � ^ ' ------------''--'—^----'—^^'—^- -------'-----------`—'^--^^~— \ � ^